胃癌早期诊断的研究

Study on early diagnosis of gastric cancer

胃癌是来源于胃黏膜上皮的恶性肿瘤,是我国最常见的恶性肿瘤之一,有较高的发病率及病死率,由于其早期诊断困难及术后复发转移等特点,对人民群众健康造成严重危害。早期诊断胃癌是患者良好预后的关键,如何诊断早期胃癌是当前胃癌研究领域的热点。近年来各种诊断新技术的出现大大提高了早期胃癌的检出率,但我国目前早期胃癌的诊治率仍低于10%,远低于日本的70%与韩国的50%。早期胃癌的发现依赖于机会性内镜筛查,由于胃镜筛查属侵入性检查、费用相对较高、人群接受度较低等原因,难以用于我国胃癌的大规模筛查,在社区开展筛查还需要解决一些落地衔接的问题、胃癌地域差异性等因素,导致早期胃癌发现率不高。本文将从各类肿瘤标志物、内镜检查、影像学检查、生物信息学、表观遗传学等方面对胃癌的早期诊断新进展作一概述。

Gastric cancer is a malignant tumor originates from the epithelium of the gastric mucosa.It is one of the most common malignant tumors in China.It has a high incidence rate and mortality.Due to its early diagnosis and postoperative recurrence and metastasis,gastric cancer is seriously harmful to the health of the people.Early diagnosis of gastric cancer is the key to good prognosis of patients.How to diagnose early gastric cancer is a hot topic in the field of gastric cancer research.In recent years,the emergence of new diagnostic techniques has greatly improved the detection rate of early gastric cancer,but the diagnosis and treatment rate of early gastric cancer in China is still lower than 10%,far lower than 70%in Japan and 50%in Korea.The discovery of early gastric cancer depends on opportunistic endoscopic screening.Because of its invasive nature,relatively high cost and low population acceptance,it is difficult to apply it to the large-scale screening of gastric cancer in China.In order to carry out the screening in the community,there are still some problems to be solved in connection with the implementation of screening,regional differences of gastric cancer and other factors,resulting in the low detection rate of early cancer.This article reviewed the new progress of early gastric cancer diagnosis from various tumor markers,endoscopy,imaging,bioinformatics,epigenetics and so on.